Report: Reimbursement for telehealth 40 percent less than for non-telehealth care

February 26, 2016

By Katie Dvorak
February 26, 2016

Reimbursement for telehealth services is much lower than non-telehealth care, according to a recent policy brief from the Health Care Cost Institute.

The institute found that the lower-than-average reimbursements for remote care, which were almost 40 percent less than for in-person care, could discourage adoption oftelemedicine, according to an announcement.

The authors of the brief, from the University of Nebraska Medical Center and the City University of New York, say that while telemedicine claims grew from 1,246 in 2009 to 2,558 in 2013, reimbursement remains low.

HCCI, for the brief, examined “billions” of claims from Aetna, Humana, Kaiser Permanente and UnitedHealthcare Group from 2009-2013. In that time, 6,506 claims were made for services related to telemedicine and 95.9 million were for non-telehealth services.

Since 2009, average reimbursements for services not including telehealth rose every year, from $57 to $61. However, telemedicine reimbursements rose about $8 between 2009-2011, but then declined “substantially” after that, going down to $38 in 2013.

“The gap between telehealth and non-telehealth reimbursements of primary care providers are likely to discourage major investments in telehealth technologies by clinics unless these technologies result in substantial cost savings to clinic operations,” the authors conclude.

Since last spring, there has been a “mix of strides and stagnation” when it comes to reimbursement for the services, according to two reports from the American Telemedicine Association. The reports did note a positive swing when it comes to reimbursement: 11 states adopted policies that improve coverage and reimbursement and only two states implemented policies that restrict coverage.

And despite continued reimbursement barriers, providers are positive about the direction in which the technology is moving.

“[T]he arrows are all moving in the right direction for growth,” John Jesser, vice president of provider engagement strategy for Anthem’s LiveHealth Online service, previously told FierceHealthIT. “Five years from now, it won’t even be called telemedicine, it’ll just be healthcare. Doctors’ offices will be Web-enabled, mobile-enabled. That progress is going to continue to happen.”